Retraining Attention to Treat Alcohol Dependence and Social Anxiety (AMP)

The purpose of this research is to test a computerized intervention for people with co-occurring social anxiety and alcohol dependence. The intervention seeks to reduce symptoms by shifting attention away from alcohol-relevant and/or socially threatening cues. The investigators expect that participants receiving alcohol or anxiety training will experience reductions in those specific symptoms compared to participants in a control condition. The investigators also expect that participants receiving combined alcohol and anxiety training will show the largest reductions in alcohol and anxiety symptoms, relative to participants in any other condition.

Alcohol Use Disorders (AUDs) and Social Anxiety Disorder are disabling and chronic conditions. In spite of these common and significantly overlapping problems, insight into the mechanisms linking alcohol dependence and social anxiety symptoms is minimal, and there are not well established treatment guidelines for this population. In this study, the investigators seek to develop a computerized intervention for individuals with symptoms of social anxiety and alcohol dependence. The intervention attempts to reduce symptoms by shifting attention away from alcohol-relevant and/or socially threatening cues. The investigators expect that participants receiving alcohol or anxiety training will experience reductions in those specific symptoms compared to participants in a control condition. The investigators also expect that participants receiving combined alcohol and anxiety training will show the largest reductions in alcohol and anxiety symptoms, relative to participants in any other condition.

Alcohol Abuse, Alcohol Dependence, Alcohol Drinking, Social Anxiety, Social Phobia, Anxiety Disorders

Anxiety Attention Training will preferentially direct participants' attention away from reminders of anxiety.

Alcohol Attention Training will preferentially direct participants' attention away from reminders of alcohol.

Placebo Anxiety Training and Placebo Alcohol Training will not preferentially direct participants' attention away from reminders of anxiety or alcohol.

The experimenter-administered Liebowitz Social Anxiety Scale (Liebowitz, 1987) was the primary measure to assess social anxiety symptoms. This well-validated instrument assesses fear and avoidance across a range of 24 social and performance situations during the course of the previous week. A total LSAS score was computed, ranging from 0 (no fear or avoidance) to 144 (the greatest level of fear and avoidance).

Baseline, weekly throughout the 4-week trial, and in the follow-up sessions (1 week and 1 month follow-ups)

The Daily Drinking Questionnaire (Collins, Parks, & Marlatt, 1985) was the primary measure used to assess weekly alcohol consumption. This calendar-based measure was administered by the experimenter once per week to monitor changes in symptoms. The measure assessed the total number of drinks in the past week.

Baseline, weekly throughout the 4-week trial, and in the follow-up sessions (1 week and 1 month follow-ups)

Inclusion Criteria: Current alcohol dependence Elevated social anxiety symptoms Willingness to consider cutting down on drinking Exclusion Criteria: Current psychosis Unmanaged manic symptoms Significant cognitive impairment Other drug use in past month Receiving cognitive behavioral therapy for alcohol use disorder or social anxiety Unable to read